Clover Health planning expansion into 101 new markets

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Clover Health, a technology company focused on health equity for underserved seniors, recently announced plans to nearly double its geographic footprint. The expansion, subject to approval from the Centers for Medicare and Medicaid Services, will make Clover's Medicare Advantage plans available to eligible individuals in a total of 209 counties across nine states.

Those eligible for Medicare in these new counties can sign up for Clover's plans during the Annual Election Period, which runs from October 15 to December 7, with coverage starting on January 1, 2022.

WHAT'S THE IMPACT

Clover currently offers its Medicare Advantage plans in 108 counties where it cares for approximately 66,300 members. The planned expansion will bring coverage to an additional 101 counties, 94 of which are in Clover's existing states of Georgia, New Jersey, South Carolina, and Texas, and seven of which are in Alabama -- marking the company's first foray into that state. Clover also has plans available in Arizona, Mississippi, Pennsylvania and Tennessee.

The expansion opens up Clover's plans primarily to seniors living in rural areas, who are more likely to face health disparities than those in more urban environments. By tapping into Cover Assistant's primary care physician network, the company seeks to improve care coordination, address gaps in care and lower overall medical expenses for those eligible for Medicare. 

Going into 2022, all of the company's plans will be operating solely under the Clover brand, and as such, Clover will discontinue its current co-branding arrangement with Walmart in eight Georgia counties. There will be no material change to benefits under those plans, and Clover expects there to be no disruption for its members.

Also, Clover intends to introduce a number of new benefits, some of which may be launched to existing Clover members as early as the third quarter of this year. For many of its plans, Clover intends to expand its over-the-counter benefit and add a grocery benefit, which would be available in many major retailers (including Walmart), additional local supermarkets and regional chains.

THE LARGER TREND

Clover's arrangement with Walmart was short-lived, as the companies teamed up to offer MA plans to eligible seniors in Georgia just in October 2020.

It marked Walmart's first steps into the insurance market, and followed other recent moves to expand into healthcare. It first remodeled 500 stores across two dozen states to include updated pharmacy areas equipped with private consultation rooms. From there, Walmart Health opened its first brick-and-mortar location in Dallas, Georgia where patients could get primary care, dental, counseling, lab services, X-rays, audiology and more.

For its part, Nashville-based Clover's workforce is distributed around the U.S. and also includes a team of technologists based in Hong Kong. The company manages care for Medicare beneficiaries in 11 states, including Arizona, Georgia, Kansas, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas and Vermont.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com